Retinopathy is any damage to the retina of the eyes, which may cause vision impairment. Retinopathy refers to retinal vascular disease, or damage to the retina caused by abnormal blood flow. Age-related macular degeneration is technically included under the umbrella term retinopathy but is discussed as a separate entity. Retinopathy, or retinal vascular disease, can be broadly categorized into proliferative and non-proliferative types. Retinopathy is an ocular manifestation of systemic disease as seen in diabetes or hypertension. Diabetes is the most common cause of retinopathy in the U. S. as of 2008. Diabetic retinopathy is the leading cause of blindness in working-aged people, it accounts for about 5% of blindness worldwide and is designated a priority eye disease by the World Health Organization. Many people do not have symptoms until late in their disease course. Patients become symptomatic when there is irreversible damage. Symptoms are not painful and can include: Vitreous hemorrhage Floaters, or small objects that drift through the field of vision Decreased visual acuity "Curtain falling" over eyes The development of retinopathy can be broken down into proliferative and non-proliferative types.
Both types cause disease by altering the normal blood flow to the retina through different mechanisms. The retina is supplied by small vessel branches from the central retinal artery. Proliferative retinopathy refers to damaged caused by abnormal blood vessel growth. Angiogenesis is a natural part of tissue growth and formation; when there is an unusually high or fast rate of angiogenesis, there is an overgrowth of blood vessels called neovascularization. In the non-proliferative type, abnormal blood flow to the retina occurs due to direct damage or compromise of the blood vessels themselves. Many causes of retinopathy may cause both proliferative and non-proliferative types, though some causes are more associated one type. Non-proliferative retinopathy is caused by direct damage or remodeling of the small blood vessels supplying the retina. Many common causes of non-proliferative damage include hypertensive retinopathy, retinopathy of prematurity, radiation retinopathy, solar retinopathy, retinopathy associated with sickle cell disease.
There are three main mechanisms of damage in non-proliferative retinopathy: blood vessel damage or remodeling, direct retinal damage, or occlusion of the blood vessels. The first mechanism is indirect damage by altering the blood vessels. In the case of hypertension, high pressures in the system causes the walls of the artery to thicken, which reduces the amount of blood flow to the retina; this reduction in flow causes tissue ischemia leading to damage. Atherosclerosis, or hardening and narrowing of blood vessels reduces flow to the retina; the second mechanism is direct damage to the retina caused by free radicals that causes oxidative damage to the retina itself. Radiation, solar retinopathy, retinopathy of prematurity fall under this category; the third common mechanism is occlusion of blood flow. This can be caused by either physically blocking the vessels of the retinal artery branches or causing the arteries to narrow. Again, the end result is reduced blood flow to the retina causing tissue damage.
Sickle cell disease compromises blood flow by causing blood to sludge, or thicken and flow through the retinal arteries. Other disorders that cause hyperviscosity syndrome may cause blood sludging. Lastly, clots or central artery thrombosis directly blocks flow to the retina causing the cells to die. Proliferative retinopathy is the result of aberrant blood flow to the retina due to blood vessel overgrowth, or neovascularization; these pathologically overgrown blood vessels are fragile and ineffective at perfusing the retinal tissues. These weak, fragile vessels are often leaky, allowing fluids and other debris to leech out into the retina, they are prone to hemorrhage due to their poor strength. This makes proliferative types of retinopathy more risky since vessel hemorrhaging leads to vision loss and blindness. Many of the causes mentioned in non-proliferative retinopathy may cause proliferative retinopathy at stages. Angiogenesis and neovascularization tend to be a manifestation of non-proliferative retinopathy.
Many types of non-proliferative retinopathies result in direct retinal damage. The body responds by trying to increase blood flow to damaged retinal tissues. Diabetes mellitus, which causes diabetic retinopathy, is the most common cause of proliferative retinopathy in the world. Genetic mutations are rare causes of certain retinopathies and are X-linked including NDP family of genes causing Norrie Disease, FEVR, Coats disease among others. There is emerging evidence that there may be a genetic predisposition in patients who develop retinopathy of prematurity and diabetic retinopathy. Trauma to the head, several diseases may cause Purtscher's retinopathy. Retinopathy is diagnosed by an optometrist during eye examination; the clinician will need to examine the retina, at the back of the eye. There are several ways to examine the retina; the clinician can directly view the retina by looking through the pupil with a light. In most cases, the clinician will dilate the pupil to make for better visualization.
Stereoscopic fundus photography is the gold standard for the diagnosis of retinopathy. Telemedicine programs are available that allow primary care clinics to take images using specially designed retinal imaging equipment which can be shared electronically with specialists at other locations for review. In 2009, Community Health Center, Inc. implemented a telem
The Iron Block Building is a four-story commercial structure with a cast-iron exterior built in 1860 in Milwaukee, Wisconsin. In 1974 it was added to the National Register of Historic Places - the only surviving building in Milwaukee with a cast iron skin - a common technique from 1850 to 1870. James Baynard Martin moved from Maryland to Milwaukee in 1845, where he dealt in grain and real estate, served as an insurance executive and banker. By 1860 he was ready to build a large speculative commercial block in downtown Milwaukee. From 1850 to 1870 there was a trend to clad some commercial buildings in cast iron panels; the panels were durable and fire-resistant, they could be applied to a structure without having skilled stonemasons on site. Martin chose that type of building, engaged Daniel D. Badger's Architectural Iron Works of New York to design it. George H. Johnson designed the building, panels were cast in New York, they were transported to Milwaukee by boat, the building was constructed in 1860.
Martin's new building was four stories tall with the basement somewhat exposed at the northwest corner - an Italianate-styled design, with round arches above the windows resting on paired decorative columns and iron surfaces deliberately grooved to look like blocks joined with mortar. At the top was a cornice with a shallow pediment in the center. Beneath the cast iron skin, most of the underlying structure is timber; the main street-level entrance suggested the Roman temple, with its own pediment and entablature resting on pairs of Corinthian columns. The building was called the Excelsior Block, for the Excelsior Lodge of Masons, whose lodge was on the top floor. At street-level, the building housed five shops. Over the years the street-level storefronts have been modified, but the upper stories are intact, except that the cornice was cut back and some iron removed. Around 1900 a 5-story brick addition was added on the south side. In 1984 the building was restored, both inside and out; the Historic American Building Survey considered the Iron Block "notable as one of Milwaukee's most prominent early commercial buildings, as one of the small number of pre-Civil War structures remaining in the central business district, as the city's chief example of the use of the cast-iron front, as the work of George H. Johnson, the English-born builder-architect who figured so in the development of building technology a century ago."
List of Milwaukee landmarks National Register of Historic Places listings in Milwaukee, Wisconsin
Information Systems Research is a quarterly peer-reviewed academic journal that covers research in the areas of information systems and information technology, including cognitive psychology, computer science, operations research, design science, organization theory and behavior and strategic management. It is published by the Institute for Operations Research and the Management Sciences and in 2007 was ranked as one of the most prestigious journals in the information systems discipline. In 2008 it was selected as one of the top 20 professional/academic journals by Bloomberg Businessweek; the editor-in-chief is Alok Gupta, preceded by Ritu Agarwal, Vallabh Sambamurthy. According to the Journal Citation Reports, the journal has a 2018 impact factor of 2.457. Official website
Charles Neville Strode Smith was an English first-class cricketer and Royal Marines officer. Born at Wedmore, Somerset in December 1898, Smith was commissioned into the Royal Marines as a probationary second lieutenant during the First World War in August 1916, he was promoted to the temporary rank of lieutenant the following September, with Smith granted the full rank following the war in September 1919. Having spent eight years as a lieutenant, he was promoted to the rank of captain in September 1927. Smith made a single appearance in first-class cricket for the Royal Navy against the Marylebone Cricket Club at Chatham in 1929. Batting twice in the match, he was dismissed for 7 runs in the Navy first-innings by Sidney Martin, while in their second-innings he was run out for 47. Two years he played minor counties cricket for Devon, making a single appearance in the 1931 Minor Counties Championship, he was made a brevet major in December 1932. Smith served with the Royal Marines during the Second World War, which saw him made an acting lieutenant colonel in May 1942.
In 1943 he was involved in the formation of No. 47 Commando. Following the war he was placed on the retired list in January 1948. After his retirement, he served for two years in the Territorial Army. Smith died in September 1955 at Devon. Charles Smith at ESPNcricinfo
USS James Monroe, a Lafayette-class ballistic missile submarine, was the only ship of the United States Navy to be named for James Monroe. She served with the United States Navy from 1963 to 1990; the contract to build James Monroe was awarded to Newport News Shipbuilding and Dry Dock Company in Newport News, Virginia on 3 February 1961 and her keel was laid down there on 31 July 1961. She was launched on 4 August 1962 sponsored by Mrs. Roswell L. Gilpatric, commissioned on 7 December 1963, with Commander William H. Sandford in command of the Blue Crew and Commander Warren R. Cobean, Jr. in command of the Gold Crew. Following shakedown off Cape Kennedy, James Monroe spent the early months of 1964 in ballistic missile tests, she departed for her first deterrent patrol in June 1964. On 17 January 1967, James Monroe completed her twelfth deterrent patrol, having operated from both Holy Loch and Rota, Spain. Preparations for the arrival of the submarine squadron went forward with haste throughout the remainder of 1978 and into 1979.
Commander Submarine Squadron 16 greeted the submarine tender USS Simon Lake, when she arrived at Kings Bay on 2 July 1979. Four days USS James Monroe entered Kings Bay and moored alongside Simon Lake's starboard side to begin a routine refit in preparation for another nuclear weapons deterrence patrol. James Monroe was decommissioned on 25 September 1990 and stricken from the Naval Vessel Register the same day. Ex-James Monroe entered the Nuclear Powered Ship and Submarine Recycling Program in Bremerton, Washington. Recycling of Ex-James Monroe was completed on 10 January 1995; this article incorporates text from the public domain Dictionary of American Naval Fighting Ships. The entry can be found here; this article includes information collected from the Naval Vessel Register, which, as a U. S. government publication, is in the public domain. The entry can be found here. Photo gallery of USS James Monroe at NavSource Naval History
Larkfield was a single-member county constituency of the Parliament of Northern Ireland. Before 1969, the area formed part of the Northern Ireland Parliament constituencies of Mid-Down and South Antrim. Larkfield was created by the Electoral Law Act 1968 as a division of County Antrim, it was located to the south-west of Belfast, straddling the Upper Malone Road, Upper Lisburn Road and M1 motorway, comprised "part of the rural district of Lisburn which consists of the district electoral divisions of Andersonstown, Ballygammon, Finaghy and Upper Malone". The boundaries of those divisions are set out in the Lisburn Rural District Order 1963; the constituency sent one MP to the House of Commons of Northern Ireland at the 1969 Northern Ireland general election. The Parliament was prorogued on 30 March 1972, under the terms of the Northern Ireland Act 1972, it was formally abolished in 1973 when the Northern Ireland Constitution Act 1973 received Royal Assent on 18 July 1973. The parliamentary representative of the division was elected using the first-past-the-post system.
Parliament prorogued 30 March 1972 and abolished 18 July 1973 Northern Ireland Parliamentary Election Results 1921-1972, compiled and edited by Sydney Elliott Northern Ireland House of Commons, 1921 - 1972 For more information about the Northern Ireland House of Commons, see http://www.election.demon.co.uk/stormont/stormont.html